“When This Is All Over…”

A good friend of mine posted on Facebook today (you know who you are), about how there are going to be many cases of PTSD when this is all over. That off-hand observation had me thinking all day long as I donned PPE, saw patients, removed PPE, cloroxed everything around me, and spoke to my colleagues on the “inside”.

PTSD (Post Traumatic Stress Disorder) is defined by the Mayo Clinic as “a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.”

Moral Injury is defined by the Syracuse University Moral Injury Project as “disruption in an individual’s confidence and expectations about one’s own or others’ motivation or capacity to behave in a just and ethical manner”.

This Pandemic is an ongoing terrifying event for those of us on the “inside”. We see and experience things that on a normal day would horrify any reasonable health worker and we shrug it off with “I’m good”, spray Virex (carcinogenic by the way) over our one -gown-a-day, and move on.

Much like in war, we are suffering Moral injury as well. The things we tolerate, the actions we take for the “greater good”, and the small acts we do to let us know we are still human are causing damage on a daily basis.

We strip outside and wash everything before setting foot at home, we don’t hug anyone anymore (loss of human contact), we obsessively disinfect everything… and death becomes just another thing, something in which you cannot invest.

Much like in war, this is not going to be over for years. When the media has moved on to the next shiny object, Health Care Workers will still see the horrors of random deaths by suffocation and kidney failure as a normal thing. We’ll still be wearing masks, shoving gloves in our pockets, and having a severe mistrust of human touch.

So yeah, “when this is over” there will be a lot of us who will leave the field, and a lot of us who won’t, but will be forever scarred and will carry the burden that our military now carries of Anger, Depression, Anxiety, Substance abuse, Insomnia, and Nightmares. I hope we will learn, because the Medical Community is much worse than any other in taking care of itself, I fear we won’t.

If not, we’ll see the same incredible suicide rate that we see in our military among those of us who “gear up and go in” on the “inside”.